DENTAL MATERIALS

(Principles and Applications)

Editors
Zohaib Khurshid
B.D.S, MRes (Biomaterials),
MFGDP (UK), FICD (USA),
FPFA (USA), MADM (USA), MIADR
Prosthodontics and Implantology, College of Dentistry,
King Faisal University, KSA

Zeeshan Sheikh
Dip.Dh, BDS, M.Sc, Ph.D
University of Toronto,
Lunenfeld-Tanenbaum Research Institute
Mt. Sinai Hospital, Toronto, Canada

Co-Editor
Muhammad Sohail Zafar
B.D.S, M.Sc (Dental Material), Ph.D (Dental Materials),
FICD (USA), FADI (USA)
Associate Professor of Dental Biomaterials
College of Dentistry, Taibah University, Saudi Arabia
Visiting Professor, RIPHAH International University, Islamabad.

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 Paramount Books (Pvt.) Ltd.

Dental Materials (Principles and Applications)

by
Zohaib Khurshid | Zeeshan Sheikh

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Second Edition...........................2014
Third Edition...............................2018

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 DEDICATION
My Late Grandfather Dr. Munawar Alvi
My Parents and Family
 PREFACE TO SECOND EDITION
Dentists will be authorized and legalized end-users of dental materials, both as students and after
graduation. During undergraduate studies, it is essential that dental materials should be taught so as to
enhance understanding of their properties and clinical uses. There are still a few challenges in this respect;
not all the dental schools have dental biomaterial science as an independent status in the curriculum. In
too many cases, the facilitation is provided by colleagues lacking commitment. Clinical procedures of
operative dentistry may be thoroughly taught but little attention is paid to the actual material properties.
It may remain unexplained what is then so special regarding certain materials that they are more often
used clinically. What does actually happen during setting of say restorative filling materials and luting
cements? We never should overlook the significance of adhesion, its applications and understanding in
contemporary dentistry.
In the retail market we have a plethora of dental textbooks with varying contents and perspectives. All of
them certainly serve well today. For a dental educator one of the problems is selecting the most appropriate
book to serve in dental facilitation. Should it cover all basic sciences behind? Hardly. Would it need delve
into the physio-chemical theories? I doubt-as we may leave such aspects for post-graduate levels. Would
we then need some fresh faces to contribute for a totally new textbook in dental biomaterials? I believe a
justified answer is: yes, this is needed.
I was both surprised and pleased when Lecturer Dr Zohaib Khurshid (of Fatima Jinnah Dental College,
Karachi, Pakistan) contacted me. For those who don’t know, he has already earned a feather to his cap by
having published a dental textbook “Dental Materials–Principles and Applications”, 1st edition, in 2010.
He invited me to contribute a chapter on dental silver amalgam to his textbook “Dental Biomaterials–
Principles and Applications”- 2nd edition. This kind invitation I accepted with great content. In addition,
the two editors of this book, Dr. Zohaib and Dr. Zeeshan Sheikh, have invited a team of contributors
representing a dynamic, expanding generation of tomorrow’s dentists from Pakistan, Canada, Saudi-
Arabia, Serbia, USA, Europe and UK. This said, we could see and conclude from the table of contents of
this book that it provides the undergraduate readers with sufficient basics of dental biomaterials.
After being introduced to dental materials and dental biomaterials, readers of “Dental Materials–Principles
and Applications” may gain a fresh insight of biomaterials in implant dentistry, endodontics, nanomaterials
in dentistry, dental silver amalgam, resin composites, dental cements and bone replacement materials.
Procedures at dental laboratories and clinics are sufficiently covered as well as dental polymeric, metallic
and ceramic materials.
I feel privileged to write this preface to the book Dr. Zohaib Khurshid and Dr. Zeeshan Sheikh have
successfully edited. The outcome of a laborious team of dental professionals and experts has now
materialized. Let me conclude by saying that Dr. Zohaib and Dr. Zeeshan are to be congratulated with
their contributing team for this cornerstone outcome in dental education and modern learning. I am
convinced that you, the reader, will agree with me, and I am confident that this book will find wide use
not only in Asia but globally.
October 17, 2013, Hong Kong, PR China

Dr. Jukka Pekka MATINLINNA 馬裕祺 博士

Dental Materials Science, Faculty of Dentistry, University of Hong Kong, Hong Kong
Visiting Prof. at King Saud University, College of Applied Medical Sciences, Riyadh, Saudi-Arabia
Visiting Prof. at Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
 PREFACE TO THIRD EDITION
The 3rd edition of ‘Dental Materials (Principles and Applications)’ by Zohaib Khurshid and his co-editors
is a useful source of knowledge and information in the field of dental material science. It provides up-
to-date information on materials that are used in the dental office and laboratory every day, emphasising
practical, clinical use, as well as the physical, chemical, and biological properties of materials. Clinical
photographs in this edition illustrate the topics, and colour plates are integrated close to related concepts
as they are discussed in each chapter. Numerous boxes and tables throughout, summarise and illustrate
fundamental concepts and compare characteristics and properties of various dental materials.
A number of distinguished contributors have added their credibility and experience to the text. Content
has been thoroughly updated to include information on the most current dental materials available.
Revised artwork gives this edition a fresh look, with high-quality illustrations and clinical photos to aid in
the visualisation of materials and procedures described. The authors have tried to cover all topics under
the subject of dental materials and hence the complete syllabus is covered. The language of the text is clear,
concise and easy to understand. This 3rd edition of ‘Dental Materials (Principles and Applications)’ would
be a beneficial book for all undergraduate students of dental sciences and a valuable addition to the library
of any dentist.

Dr. Naresh Kumar

Associate Professor
Dow International Dental College (DIDC)
Dow University of Health and Sciences (DUHS)
Karachi
Pakistan
 FOREWORD
Over the past few years dental materials have undergone considerable development. Current
trends focus on aesthetics, conservation and remineralisation of tooth structure, with “Biomimetic
Dentistry” lying at the heart of any restorative technique. Furthermore, the Minamata Treaty and the
EU Mercury Regulations have advocated a phase down of the use of dental amalgams, escalating the
demands for newer and better materials. Due to the development of machinable ceramics, CAD-
CAM technology now sits at the heart of dentistry. These developments have once again placed the
subject Dental Materials into the limelight. It would be virtually impossible to keep up to par with
the changing trends without having an in-depth and up-to-date knowledge of the science of dental
materials.
In my opinion, the authors of this textbook have successfully accomplished the difficult task of
reviewing current literature and putting together an impressive textbook which covers the latest
information in the field. This information coupled with the easy to follow structure provides a great
source for enhancing the readers’ knowledge.

Dr. Saroash Shahid

Lecturer in Dental Biomaterials and Oral Biology
Centre for Oral Bioengineering
Institute of Dentistry
Barts and the London, School of Medicine and Dentistry
London, United Kingdom
 ACKNOWLEDGEMENT
The authors express their thanks to the following individuals for their contributions:
To our professors and mentors, who imparted their knowledge and wisdom, enabling us to undertake
this project of publishing a book. To the contributing authors who provided us with their expertise
and chapters. Their acceptance of our suggestions and editing has been very much appreciated. The
dental students, who appreciated the first edition of this book and encouraged us to move forward and
strive to make the second edition better, we thank them for their ongoing cooperation and dedication
to this project during their busy schedules. We thank all the above for their ongoing cooperation and
dedication to this project in the midst of their busy schedules. And lastly, to the team at Paramount
Books (Pvt.) Ltd.
 CONTRIBUTORS
Prof. Dr. Jukka Pekka Matinlinna Dr. Shujah A. Khan
Professor of Dental Materials Science B.D.S, MDS (Prosthodontics) (student)
University of Hong Kong, Dr. Ishrat-ul-Ebad Khan Institute of Oral
Faculty of Dentistry, Health Sciences (DIKIOHS)
Hong Kong Karachi, Pakistan
Eng. Faaz Butt Dr. Maria Mali
Lecturer and Ph.D. (Student), B.D.S, C-Ortho, MDS Ortho (Student)
Materials and Metallurgy NED University, College of Dentistry,
Karachi, Pakistan RIPHAH International University,
Islamabad, Pakistan
Dr. Shariq Najeeb
B.D.S, M.Sc (Dental Materials), Dr. John C. Comisi
Lecturer D.D.S, M.A.G.D
College of Dentistry, Al-Farabi Colleges, Clinical Instructor of Dentistry,
Riyadh, KSA University of Rochester School of Medicine
and Dentistry,
Dr. Samina Khan
USA
B.D.S, M.Sc
College of Dentistry, Dr. Jonathan Dixon
University of Birmingham, UK Dental Biomaterials, Preventive and Minimally
Invasive Dentistry,
Dr. Fahad Siddique
Departamento de Odontología, Facultad de
B.D.S, M.Sc (Oral Health Sciences), Ciencias de la Salud
M.Sc (Pediatric Dentistry), USA Universidad CEU-Cardenal Herrera, C/Del
Department of Pediatric Dentistry, Pozo s/n, Alfara del
Rutgers School of Dental Medicine, Newark, Patriarca 46115-Valencia, Spain
NJ, USA
Prof. Salvatore Sauro
Dr. Adeel Mudasser
Dental Biomaterials, Preventive and Minimally
B.D.S, FCPS-I (Orthodontics) Invasive Dentistry,
Senior Registrar Orthodontics Departamento de Odontología, Facultad de
Dow Dental College, DUHS, Ciencias de la Salud
Karachi, Pakistan Universidad CEU-Cardenal Herrera, C/Del
Dr. Vesna Miletic Pozo s/n, Alfara del
Patriarca 46115-Valencia, Spain
B.D.S, M.Sc, Ph.D.
Assistant Professor Dr. Saad Bin Qassim
Department of Restorative Odontology and B.D.S, M.Sc, Ph.D, C-Perio, Dip-Implants,
Endodontic Associate Professor,
School of Dental Medicine Faculty of Dentistry,
University of Belgrade, Dar Al Uloom University, KSA
Post-doctoral Researcher,
University of Edinburgh, UK and KU Leuven,
Belgium
 CONTENTS
Chapter Titles Page
1 Introduction to Sciences of Dental Material 1
Zohaib, Sohail and Zeeshan
2 Characterization of Biomaterials in Relation to Dentistry 3
Faaz and Zohaib
3 Gypsum Products in Dentistry 11
Maria, Zohaib and Sohail
4 Dental Waxes 27
Fahad
5 Investment and Refractory Dies 35
Zohaib and Maria
6 Application of Metals and Alloys in Dentistry 41
Faaz, Adeel and Zohaib
7 Casting Procedure for Dental Alloys 69
Maria, Zohaib and Adeel
8 Dental Implants and Their Surface Modifications 79
Shariq and Prof. Jukka PM
9 Application of Polymer Technology in Dentistry 85
Maria, Zohaib and Sohail
10 Dental Impression Materials 105
Zohaib and Sohail
11 Ceramic Products in Dentistry 129
Zohaib and Sohail
12 Dental Amalgam 139
Prof. Jukka PM
13 Dental Resin-Based Composite Chemistry and Its Uses 145
Zohaib and Samina
14 Glass Ionomer Cements and Their Modifications 159
Zohaib and Sohail
15 Dental Adhesive Systems 169
Vesna Miletic
16 Dental Cements 183
Zohaib and Sohail
17 Hybridization VS. Biomineralization: An Evolution for Dental Restorations 199
John C. Comisi
18 Regenerative Dentistry 213
Saad Bin Qassim
19 Degradation and Durability of Resin-Dentine Hybrid Layers 219
Jonathan Dixon and Salvatore Sauro
20 Introduction to Partial Denture 231
Shujah
Index 238
Introduction to Sciences of
Dental Material
Zohaib, Sohail and Zeeshan
DENTAL BIOMATERIALS
A science that deals with the study of materials
used in dentistry, which includes chemical prop-
erties, physical properties, manipulation and
their applications in dental practice (Fig. 1.1).
Fig. 1.1: Lab analysis.
TYPES OF MATERIALS
Preventive Materials
Sealants, liners, bases
Restorative Materials
Silicate, GIC, composites, metallic inlays
Auxillary Materials
Impression materials, casts, waxes
OBJECTIVES OF THE DENTAL
BIOMATERIAL SCIENCES ARE TO
• Know the proper usage of dental materials
• Know the physical and chemical properties
of dental materials
Chapter
1
• Understand proper manipulation of materi-
als in dental profession
• Stimulate further research so we can further
improve the quality of the material
• Introduce the students to the materials used
in dentistry
• Bridge the gap between knowledge from
chemistry, physics, etc. with dental materials
• Provide certain criteria on selection of facts
and propaganda
GOAL OF DENTISTRY
Maintain or improve the quality of life of dental
patients by preventing disease, relieving pain,
improving mastication efficiency, enhancing
speech and improving the general appearance of
patients.
BRANCHES OF DENTISTRY
ASSOCIATED WITH THE SUBJECT
Restorative Dentistry
• Branch of dentistry that deals with the pre-
vention and treatment.
• Deals with the restoration of original func-
tion and color of natural teeth.
Prosthodontics
• Branch of dentistry that deals with the
replacement of function and aesthetics.
• Three types of appliances are:
˚ Fixed Partial Denture
Replacement of a single tooth or a seg-
ment of teeth.
1
Characterization of Biomaterials Chapter

2
in Relation to Dentistry
Faaz and Zohaib

INTRODUCTION • The material properties are illustrated in

• Dental biomaterials are subjected to a very
hostile environment, in which pH, salivary
flow and mechanical loading fluctuate con-
stantly and often rapidly. These challenges
require substantial research and develop-
ment to provide products for the clinician.
Much of this is possible through the appli-
cation of fundamental concepts of material
sciences.
• Understanding properties of polymer ce-
ramics and metal is crucial their selection
and design in dental restorations. It is im-
portant to know the comparative values
properties in different restorative material; it
is also essential to know quality of the sup-
porting and investing hard and soft tissue.
(Fig. 2.1).
ATOMIC BUILDING BLOCKS
• All materials are built up from atoms and
molecules, so it is not surprising that there is
a close relationship between the atomic basis
of a material and its properties.
• Important in this context are nature of
the atoms and the ways in which they are
arranged.
• When two atoms are brought together they
link to form a molecule, and the bond that
in formed between them is called primary
bonding.

Materials Characterization

During Storage
(before use)
Shelf life

Set Material During Setting During mixing

• Mechanical properties • Rate of set • Method of dispersion
• Physical properties • Working time • Mixing time
• Thermal properties • Setting time • Viscosity time
• Chemical properties • Temperature rise on setting
• Biological properties • Dimensional changes

Fig. 2.1: Description of mechanical properties.

3

Gypsum Products in Dentistry
Maria, Zohaib and Sohail
INTRODUCTION
Gypsum is a mineral mined in various parts of
the world and is also produced as a byproduct
of fuel gas desulfurization in some of the coal-
fired electric power plants. It is white powdery
mineral with the chemical name calcium
sulphate dihydrate (CaSO4.2H2O). Its product
used in dentistry are based on calcium sulphate
hemihydrates (CaSO4. H2O). Various crystalline
forms of gypsum such as selenite and alabaster
exist in nature (Fig. 3.1).
Fig. 3.1: Showing crystal form of gypsum.
Dental plaster, dental stone, high-strength dental
stone and casting investment constitute gypsum
products. They are supplied as hemihydrates
powder that is produced by heating ground
gypsum particles. When mixed with water the
mixture reverts back to gypsum.
A mixture of plaster (gypsum product), lime and
water is used in joining the stone blocks of ancient
Egypt’s pyramids. Gypsum and gypsum products
Chapter
3
are used today for many applications including
building construction, soil conditioning, food
additives, pharmaceutical uses, medical devices
and dental applications. Main uses in dentistry
include casts on models, dies and investments.
DENTAL CAST
It is dimensionally accurate positive replica of the
teeth and the surrounding oral structures made
by producing impression [negative replica] with
a durable hard material (Fig. 3.2).
Fig. 3.2: Dental cast.
REQUIREMENTS OF DENTAL CAST
MATERIAL
a. Should have good dimensional accuracy.
b. Should have adequate mechanical properties.
c. Should have good dimensional stability after
setting.
d. Should be fluid at the time of pouring so
that it gives fine details.
11
 Chapter

4
Dental Waxes
Fahad

INTRODUCTION Processing Waxes

Dental waxes primarily consist of two or more Sticky wax
components which may either be natural or
Carding Wax
synthetic waxes, resins, oils, fats and pigments.
Appropriate blending of components is done to Boxing wax
achieve desirable properties of the material for a
specific application. Bite Registration Waxes
Waxes are thermoplastic materials which allow Bite registration wax
them to be mouldable above a specific temper- Connective wax
ature and to be transformed into a solid state,
when cooled. In other words, waxes remain 2. ACCORDING TO SOURCES
solid at room temperature, but melt when tem-
perature is increased without decomposition, to Sources
form mobile liquids. This thermoplastic proper-
Natural Synthetic
ty makes them handy for a range of applications
in dentistry. Dental waxes have poor mechanical Mineral Animal Plant Polyethylene Wax
Paraffin wax Bees wax Carnauba wax
properties, but due to their thermoplastic nature Micro crystalline Spermaceti wax Candelilla wax
they are commonly used to form wax patterns Montan wax Japan wax
for dental appliances (e.g. dentures) before cast-
ing (shown in Fig. 4.1). Waxes are used in pattern
WAX PATTERN
formation of inlays, crowns, pontics, partial and
complete dentures. Wax patterns are formed on a stone model, die
In dentistry, waxes usually serve the purpose of or on a prepared cavity in the mouth during
wax pattern construction. They may however fabrication of dental appliances. These patterns
aid in other procedures as well e.g., at the bite determine the final shape and size of the
registration stage of complete denture fabrication appliance or restoration being casted through
and to record impression of edentulous areas. a technique known as the lost-wax technique. In
lost-wax technique, the wax is burned out or
CLASSIFICATION ‘lost’, leaving behind a space (mould) which is
Waxes can be classified in two ways: then replaced by polymer or alloy depending on
the appliance under production, e.g. complete
1. ACCORDING TO DENTAL USE denture or a metal crown.
Pattern Waxes To carry out the lost-wax technique, waxes must
exhibit few desirable characteristics as listed
Inlay wax
below:
Casting wax
1. Conforming to the exact contour of appli-
Modelling wax ance that is being constructed.

27

Investment and Refractory Dies
Zohaib and Maria
INTRODUCTION
• After the production of wax pattern (either
direct or indirect methods), the wax pattern
is embedded in an investment material.
• When the investment sets hard, the wax and
sprue are removed either by softening or
burning it with an alloy by using or ceramic
casting technique.
TYPES OF WAX PATTERN
For acrylic dentures
• Wax pattern, in which the teeth have been
setup, is embedded in a two-part mould, made
up of either plaster of paris or dental stones, or
metal container which is known as ‘Flask’.
The wax is removed by boiling H2O leaving
the teeth embedded in the set gypsum.
• The space of wax is subsequently filled with
the polymeric denture base material e.g.
Acrylic Resin Material (Fig. 5.1).
Fig. 5.1: Showing packing of acrylic.
Chapter
5
For casting metals and alloys
• Wax pattern of an inlay or other casts
restoration is embedded in a Heat-Resistant
investment material, which is capable of
setting to a hard mass as shown in Fig. 5.2
(a, b).
• The wax is removed from such mould usually
by burning out or Lost Wax-Technique, then
the space of wax is replaced by Molten Alloy.
DENTAL INVESTMENT MATERIAL
It is a ceramic based material which is suitable
for forming a mould into which a metal or alloy
is appropriately cast. Reason for reinforcing
ceramic is to produce material which withstands
high temperature associated with the casting
procedure and not to chemically react with cast
metal. The procedure for forming the mould is
described as “investing”.
Fig. 5.2 (a): Showing investment procedure.
35
Application of Metals and Chapter

6
Alloys in Dentistry
Faaz, Adeel and Zohaib

CRYSTAL STRUCTURE OF METALS AND ALLOYS

INTRODUCTION
Metals are defined as “An opaque lustrous chem-
ical substance which is a good conductor of heat
and electricity and when polished is a good re-
flector of light”. They are used not only as re-
storative materials but also as tools and in ortho-
pedic surgeries.
They can be base metals or noble/inert metals. In
dentistry most frequently used metals are:
become dangerous for dental applications. To in-
crease their anticorrosion behaviour they are used
in combinations. e.g. Iron(Fe), Copper(Cu) etc.
CLASSIFICATION OF METALS
In existing elements found in periodic table; 70%
are metals. They are classified in various types
i.e. Alkali, alkaline earth metals, transition and
rare earth metals.

1. NOBLE METALS 1. ACCORDING TO THEIR

This group of metals consists of mainly anticor-
rosive metals. They are highly inert since they
cannot form oxide layer. In case of gold the layer
of oxide which forms is highly unstable.
Gold Au
Silver/Argentums Ag
Platinum Group metals Pt
2. BASE METALS
Base metals are usually used with combination
of other metals. These metals are prone to ox-
ide layer formation which does not make them
suitable for dental applications. Once oxide lay-
er is formed these metals lose their integrity and
COMPOSITION
Pure metals: Metals composed of only one
metallic element. For example: gold, silver, iron,
copper etc.
Metal alloys: An alloy is a homogeneous com-
bination of two or more metals. For example:
IB bronze, brass, steel, etc.
IB
VIIIB 2. ACCORDING TO THEIR IRON
CONTENT
Ferrous: These are iron (the pure metal) or alloys
that contain iron (steel and cast iron).
Non ferrous: These are pure metals which aren’t
iron (e.g. copper) or metal alloys that don’t contain
iron e.g. bronze, copper, aluminium, lead, zinc,
tin, brass, titanium, chrome, silver, gold.

Classification of Metals:
Metals

Alkaline - Rare -
Actinide Alkali Noble Rare Transition
earth earth

41
Casting Procedure for Dental Chapter

7
Alloys
Maria, Zohaib and Adeel

CASTING
Casting is the process by which a wax pattern of
a restoration is converted to a replicate in a dental Molten
alloy (Fig. 7.1). The casting process is used to make alloy
dental restorations such as inlays, onlays, crowns,
bridges and removable partial dentures (Fig. 7.2).
In dentistry, all casting is done using same form
or adaptation of the lost wax technique. The lost
wax technique has been used for centuries but Mould
its use in dentistry was not common until 1907 Asbestos
when W.H. Taggart introduced his technique subst. liner
with the casting machine. Investment
Metallic ring
The process consists of surrounding the wax pat-
tern with a mold made of heat resistant invest-
ment material, eliminating the wax by heating
Fig. 7.1: Illustration showing the procedure of casting.
and then introducing molten metal into the mold
through a channel called sprue. In dentistry the
resulting casting must be an accurate reproduc-
tion of the wax pattern in both surface details and
overall dimension. Small variation in investing or
casting can significantly affect the quality of the
final restoration. Successful castings depend on
attention to detail and consistency of technique.
An understanding of the exact influence of each
variable in the technique is important so rational
decisions can be made to modify the technique as
needed for a given procedure.
Fig. 7.2: Porcelain fused to metal crown.
STEPS IN MAKING A CAST • Attachment of sprue former
RESTORATION • Ring liner placement
Following are the Steps of Making Metal • Investing
Crown • Burn out or wax elimination
• Tooth/teeth preparation • Casting
• Impression • Recovery
• Model pouring • Pickling
• Wax pattern fabrication • Polishing

69
Dental Implants and Their
Surface Modifications
Shariq and Prof. Jukka PM
INTRODUCTION
A dental implant is a metallic prosthesis that
functions as a root for supporting artificial teeth
to replace missing or lost dentition (Fig. 8.1).
Over one million dental implants are placed
every year. An implant is in direct contact with
the alveolar bone. The idea of placing ‘prosthe-
ses’ such as shells into the jaw bone dates back to
the ancient Mayan civilization; archeological ex-
cavation sites have led to the discovery of human
jaw bone with tooth-shaped shells embedded in
it. The concept of modern implantology was dis-
covered rather accidentally by P. I. Brånemark.
While conducting research on bone regenera-
tion around titanium chambers inserted in rabit
femurs, he noticed that after several months he
was unable to remove them. He later developed
an implant system which could be used to sup-
port dental prostheses. The requirements of
dental implants are: biocompatibility, stability,
acceptable function and ease of manufacture.
Prior to the introduction of the Brånemark
implant system, sub-periosteal implants were
used. Sub-periosteal consisted of a cobalt-chro-
mium framework resting over the bone under
the oral mucosa. This design is now outdated
and has been replaced by osseointegrated dental
implants. Another older type of implant is the
blade-vent implant. In these implants, one end
of the implant (the blade) is inserted into the
bone whilst the other end projects through the
mucosa into the oral cavity. These implants carry
a very high risk of infection and ultimately, im-
plant failure.
OSSEOINTEGRATION
When any biomaterial is inserted into the liv-
ing tissue, almost immediately, it is covered by
Chapter
8
Dental implant
Replacement
Natural crown
tooth
Abutment
Gums
Root
Implant
Bone
Fig. 8.1: Comparison between a dental implant (right)
and a natural tooth (left).
cell adhesion proteins. Surface characteristics
such as wettability and charges affect the quali-
ty of absorption of these proteins onto the im-
plant. Cells then interact with these proteins to
adhere to the implant surface. Similarly in bone
tissue, osteoblasts, the bone forming cells, are
laid down onto the implant surface and conse-
quently, there is a direct bone-implant interface
formed. This interface is known as osseointegra-
tion. If there is a loose connective tissue formed
instead of a bone-implant interface, the implant
fails. osseointegration is the main factor that dic-
tates the success of dental implants. According
to Brånemark, osseointegration depends on the
quality of the bone, surface morphology of the
implant, the implant material, surgical technique
employed to place the implant and the design of
79
Application of Polymer
Technology in Dentistry
Maria, Zohaib and Sohail
INTRODUCTION
Polymer science or macromolecular science is
a subfield of materials science concerned with
polymers, primarily synthetic polymers. The
field of polymer science comprises three main
sub-disciplines.
Polymer chemistry or macromolecular chem-
istry which deals with the chemical synthe-
sis and chemical properties of polymers or
macromolecules.
1. Polymer physics is concerned with the bulk
properties of polymer materials and engi-
neering applications.
2. Polymer characterization is concerned with
the analysis of chemical structure and mor-
phology and the determination of physical
properties in relation to compositional and
structural parameters.
3. Polymers (poly = many, mer = unit) are
made by linking small molecules (mers)
through primary covalent bonding in the main
molecular chain backbone with C, N, O, Si,
etc (Fig. 9.1). Polymers have a major role in
most areas of dentistry.
Polymerization
Fig. 9.1: Illustration representing the process of polymerization.
Chapter
9
Nowadays, synthetic polymers have been wide-
ly used in both restorative and prosthetic den-
tistry for over five decades, and used in medical
disposable supplies, dental materials, implants,
dressings, bleaching tray, extracorporeal devices,
encapsulants, polymeric drug delivery systems,
tissue engineering scaffold, and brackets in or-
thodontic treatment.
Applications for acrylic polymers based on func-
tional methacrylate, include dentures, (Fig. 9.2
and 9.3) restorative materials, relining and repair
material, soft liners, bonding agents, temporary
crown and bridges. Elastomeric materials such
as silicones, polysulphides and alginates are used
for recording impressions of the hard and soft
oral tissues, which are then utilized for con-
structing appliances outside the mouth. Water-
soluble polymers are used in adhesive dental
cements. Polymer composites an important part
of restorative dentistry, at present is the material
with the widest range of indications and is vital
to modern dentistry.
Covalent bond
85
 Chapter

10
Dental Impression Materials
Zohaib and Sohail

INTRODUCTION
Those materials that are used to take impression
of teeth and surrounding structures of oral cavity
for making accurate prosthesis of the patient.
How do we use impression material?

A. Examine the Patient

With the help of impression tray select the size
of the tray, and check the patient whether it is
edentulous/dentulous.

B. Load of Material in Tray

Select the material which type of it would be
used to take such impression (Fig. 10.1).

C. Take Impression Fig. 10.1: Metallic stock trays.

The material should be fluid enough when it is
inserted in the oral cavity in order to adapt the
oral tissues (Fig. 10.2).

D. Pour Model
The model is poured with dental stone plaster.
For examination of oral tissues or for making
prosthesis e.g. Partial denture, crown and bridge.

Fig. 10.2: Checking impression tray size in Patients

mouth.

105
 Chapter

11
Ceramic Products in Dentistry
Zohaib and Sohail

INTRODUCTION

Ceramics is driven from Greek wovd

“KERAMOS” meaning burnt stuff but it is re-
lated to material produced by firing or burning.
The first ceramics fabricated by man were earth-
enware pots used for domestic purpose. This
material is opaque, relatively weak and porous
and would be unsuitable for dental applications.
Silica and feldspar was added to improve trans-
lucency and strength required for dental appli-
cation and was given the name of Porcelain also
known as Conventional or feldsphatic porcelain.
Dentistry has turned to porcelain for the pro-
duction of artificial teeth, crowns, bridges and (c)
veneers (Fig. 11.1). Fig. 11.1: A few applications of ceramic in dentistry.
(a) Veneers, (b) All-ceramic Crown, (c) Indirect Inlays.

CLASSIFICATION OF DENTAL
PORCELAIN
Dental porcelain can be classified as follow:

1. ACCORDING TO FIRING
TEMPERATURE
• High fusing-1300 °C
• Medium fusing-1100-1300 °C
(a) • Low fusing–850 °C
• Ultra low fusing–less than 850 °C

2. ACCORDING TO TYPES
• Feldsphatic porcelain
• Aluminous porcelain
• Cast glass ceramic
• Lucite reinforced
• Glass infiltrate

(b)

129

Dental Amalgam
Prof. Jukka PM
INTRODUCTION
Some dental materials are used to restore
diseased (caries, secondary caries), traumatized
(incl. wear) or lost teeth, or neighboring tooth
structures (and tissues), and rehabilitate biting
functions.
Dental materials can be classified as restorative
materials, preventive materials and auxiliary ma-
terials. On the other hand, any material that is
used for the above described purpose may be re-
garded as a biomaterial.
IDEALLY RESTORATIVE DENTAL
MATERIALS SHOULD BE
• Inert
• Biocompatible
• Non-irritant
• Non-cytotoxic
• Not carcinogenic or mutagenic
• Not appreciably soluble in oral fluids
• Dimensionally stable
• Possessing adequate biomechanical
properties
• Acceptable to patients
• Cleansable
• Indistinguishable from natural tissue
• Long lasting when a permanent restoration
done
• Induce fast healing process (if relevant)
• Possessing adhesion to tooth tissues (if
relevant)
• Osteoconductive and capable of osseointe-
gration (if relevant)
Chapter
12
Examples
Restorative dental materials can be classified as
(a) direct and (b) indirect materials.
Direct restorative materials, such as resin-based
composites (resin composites, filled resins), den-
tal silver amalgam and glass ionomer cements
(GIC), are used directly inside the oral cavity in
a plastic form which will then set to restore the
function of teeth.
Provisional (temporary) dental materials are used
for a limited planned period of time, usually
a few days or a few weeks. It may be necessary
for the dentist to decide the definitive treatment,
such as in the case of very deep cavities. In such a
case the application of zinc oxide (ZnO) eugenol
cement (ZOE) as a temporary filling material
may be used. Also, a prepared tooth may need
to be covered with an acrylic temporary crown
before the definitive crown is prepared by the
dental laboratory.
DENTAL SILVER AMALGAM
An amalgam is an alloy that contains mercury
(Hg) as one of its constituents. Mercury is a
liquid metal at room temperature.
Dental silver amalgam has been the most com-
monly used direct restorative filling material hav-
ing served for more than 160 years. It is a perma-
nent restorative material mainly used to restore
cavities of decayed permanent posterior teeth. It
is has been a very effective and economical re-
storative material over a long time. Its challenges
may be related to its appearance and while some
have expressed doubts about its safety, there
are no substantiated problems. One of the cur-
rent aspects in the discussion is whether resin
139
Dental Resin-Based Composite Chapter

13
Chemistry and Its Uses
Zohaib and Samina

INTRODUCTION e. It has good thermal insulator.

With the advancement in polymer science,
new resin reinforced by means of fillers has
been developed. In general, the properties of
these composite resins are superior to those of
conventional unfilled resins like acrylic resin.
Historically, silicate cements were developed
first as esthetic material followed by acrylic
resins, and then by composite resins.
ACRYLIC RESINS
INTRODUCTION
That type of unfilled direct resins have been large-
ly replaced by the composite resins. Discussion
on it is necessary to understand the chemistry and
properties of the newer resin systems.
MODE OF SUPPLY
They are supplied as powder and liquid.
COMPOSITION
Powder
Polymethyl methacrylate, Benzoyl peroxide
(initiator), Colour pigments.
Liquid
Methlymethacrylate monomer N, N-dimeltyl-
P-toluidine (activator)
ADVANTAGES
a. Less prone to erode.
b. It has low solubility.
c. It is less acidic.
d. It is less brittle.
f. It has good appearance.
DISADVANTAGES
a. Level of residual methyl methacrylate mon-
omer, which is irritant.
b. Material undergoes setting contraction (6% by
volume) and it can produce marginal gap.
c. It has low value of modulus of elasticity and
it indicates that acrylic resin is a far more
flexible than either enamel or dentine.
d. It has low compressive strength and hard-
ness value and this value reflects that it has
poor durability.
Current Status
This material is still in use for temporary crown
and bridge costruction.
COMPOSITE
In materials sciences it is defined as a product,
which consists of at least two distinct phases
normally formed by blending together compo-
nents having different structures and properties.
Composite is made by combining two or more
dissimilar material in such a way that the result-
ant material has a property superior to any of its
parental ones.
Typical engineered composite materials include:
a. Composite building materials such as ce-
ment, concrete
b. Reinforced plastics such as fiber-reinforced
polymer
c. Metal composites
d. Ceramic composites (composite ceramic
and metal matrices).

145
Glass Ionomer Cements and
Their Modifications
Zohaib and Sohail
INTRODUCTION
Glass ionomer restorative materials are hybrids
of silicate and polycarboxylate cements. It
consists of interpenetrating network of inorganic
and organic components forming a matrix in
which particles of unreacted glass are embedded
(Fig. 14.1).
Polycarboxylate were developed several years
earlier and were the first dental cements for
which an inherent adhesion to tooth substance
could be demonstrated. In late 1960s Glass-
ionomer became available as a result of the pi-
oneering studies of Alan Wilson and Brian Kent
at the Laboratory of the Government Chemist,
London. Commercial dental cements of this
type were launched in 1975, though these had
very inferior properties compared with the ma-
terials available today.
When zinc oxide of the polycarboxylate material
was replaced by a reactive ion leachable glass
similar to that used previously in silicate cements
a storage, less soluble and more translucent
cement could be produced.
Fig. 14.1: GIC restorative material.
Chapter
14
CLASSIFICATION
Types and their uses:
Type I: For luting cast restorations and ortho-
dontic bands
Type II(A): Aesthetics restorative cements, used
for class III and class V cavities
Type II(B): Reinforced restorative material,
mainly used for core build up
1. Miracle mix–GIC powder + Ag amalgam
alloy powder
2. Class cermet–GIC powder + pure Au/Ag
(mostly Ag), also known as ketac silver
Type III: Lining cement, base
Type IV: Visible light activated liners/bases
Type V: Glass1 ionomer for stabilization and
protection
Type VI: Atraumatic Restorative Technique(ART)
in anterior teeth
Type VII: High viscous/condensable glass iono-
mers, ART for posterior teeth
SUPPLIED AS
• Powder and liquid
• Powder mixed with water
• Encapsulated form
159

Dental Adhesive Systems
Vesna Miletic
INTRODUCTION
Dental adhesive systems form an intermediate
layer between the tooth and restoration, effec-
tively bonding a resin-based restorative material
or cement and hard dental tissues, enamel and
dentine. Dental adhesives are based on a blend of
resin monomers, mostly methacrylates and di-
methacrylates. Adhesion to enamel and dentine
is primarily based on “micro-mechanical inter-
locking” through superficial demineralisation of
enamel and dentine followed by adhesive infil-
tration into the demineralised tissue [1] though
certain monomers are able to chemically bond
to hydroxyapatite [2]. This inter-phase formed
by adhesive resin and tooth tissue is called the
“hybrid layer” [3]. On the other side, the adhe-
sive forms covalent bonds with monomers in
resin-based composite or cement. Similarly to
resin-based composites, adhesives too harden
through the process of polymerization which
may be light-or chemically-initiated. Most con-
temporary adhesives belong to the light-cured
rather than chemically-cured materials. Some
adhesives contain both photo-initiators and
chemically curing initiators and are referred to as
dual-cured adhesives.
Dental adhesives are often referred to as “dentine
bonding agents” or “dentine adhesives”. This
terminology most likely originates from the
scientific focus being on dentine bonding which
remains to be a challenge as oppose to enamel
bonding which proves to be reliable and durable
following phosphoric acid etching and adhesive
application. Since the adhesives are applied to
enamel as well as to dentine, the term “dental
adhesive system” or “dental adhesive” is more
appropriate.
Chapter
15
COMPOSITION
Dental adhesives consist of resin monomers,
solvents, initiators, stabilizers and may contain
fillers. There are three categories of resin mon-
omers: functional, cross-linking and intermedi-
ary monomers. Functional monomers contain
at least one acidic group, -COOH or –H2PO3.
Their primary role is interaction with Ca ions
from hydroxyapatite that leads to demineralisa-
tion. Functional monomers are also responsible
for enhanced wetting and promoting adhesion
into the substrate. Polymerizable methacrylate
groups (C=C) allow functional monomers to
become part of polymer chains. The so-called
spacer groups between the methacrylate and
acidic groups affect properties such as acidi-
ty, hydrophilicity, hydrolytical stability. Among
the most common functional monomers are
HEMA, 4-META, 10-MDP, Phenyl-P1.
Cross-linking monomers are mostly dimeth-
acrylates, such as BisGMA, UDMA, TEGDMA
and BisEMA2, which contain two polymerizable
methacrylate groups (C=C). During polym-
erization, these monomers form cross-linked
polymers which are responsible for mechanical
properties of the adhesive [4]. Cross-linking
monomers are well solvated in organic solvents,
ethanol and acetone, and only limitedly in water
due to their hydrophobic nature. Cross-linking
monomers are often used in conjunction to
• HEMA-2-hydroxyethyl methacrylate; 4-ME-
TA-4-methacryloyloxyethyl trimellitate an-
hydride; 10-MDP-10-methacryloyloxydecyl
dihydrogenphosphate; Phenyl-P-2-(methacry-
loyloxyethyl)phenyl hydrogenphosphate
• BisGMA-bisphenol A diglycidyl methacrylate;
UDMA-urethane dimethacrylate; TEGDMA-
triethyleneglycol dimethacrylate; BisEMA-
ethoxylated bisphenol A glycol dimethacrylate
169
Dental Cements
Zohaib and Sohail
INTRODUCTION
Cements are defined as a material that produces
a mechanical interlocking effect on hardening. In
dentistry, cements are defined as a Substance that
hardens to act as a base, liner filling materials and
luting or adhesive to build prostheses to tooth
structure or to each other.
Dental cements are used for a variety of dental
applications e.g. use as luting agents, pulp-pro-
tecting agents and cavity-lining material. Dental
cements are hard, brittle materials formed by
mixing powder and liquid together. They are ei-
ther resin cements or acid-base cements.
As these materials are used in a very sensitive en-
vironment so they must fulfill basic requirement
which are as follows, discussed under particular
category.
LINING MATERIALS
Certain filling materials are not suitable for
placing directly into a freshly prepared cavity.
In such circumstances, a layer of cavity lining
material is placed in the occlusal floor of the
cavity, and on the pulpal axial dentine wall for
class II cavities, prior to placement of the filling.
REQUIREMENTS
Depends on the
a. Depth of the cavity
b. Thickness of residual dentine
c. Type of filling material
PURPOSE OF LINING OR BASE
a. To acts as a barrier between the filling mate-
rial and the dentine which, by virtue of the
dentinal tubules, has direct access to the sen-
sitive pulp
Chapter
16
b. To provide sufficient mechanical strength
to resist disruption during the placement of
filling.
c. To provide a firm, rigid base this will ade-
quately support the filling above it.
d. To provide a thermal, chemical and electrical
barrier (Fig. 16.1).
Chemical Thermal Galvanic
attack stock effect
Cavity Lining
Vital pulp
Fig. 16.1: Diagram illustrating the way in which a
cavity lining protects the dental pulp.
A. Thermal Barrier
The cavity lining or base is often expected to form
a thermally insulating barrier in order to protect
the pulp from sudden intolerable changes in
temperature. A thermally insulating cavity lining
is particularly required when a metallic filling,
such as amalgam is used because the thermal
diffusivity value for amalgam is about 40 times
greater than that for dentine.
1. In deep cavities
• Having only a thin residual layer of dentine,
and there is a danger of “thermal shock” to
the pulp when the patient takes hot or cold.
183
Hybridization VS.
Biomineralization: An Evolution
for Dental Restorations
John C. Comisi
ABSTRACT
In the early 1980’s the dentin hybridization model
was proposed. It was described as a bioengineered
tissue integration of resin into the living dentin
of the tooth. Over the following years there
have been generations of dentin hybridization
adhesives created to attempt to overcome the
shortcomings of the previous generations or to
attempt to make the process easier for clinical
application. However, it has been determined
that the average life span of typical resin bonded
composite restorations is 5.7 years at a cost of
approximately five billion dollars annually in
the United States alone. Various agents have
been proposed and subsequently used in an
attempt to create more long lasting hybrid
bonds. However, it has been stated that the use
of these agents applied either separately or mixed
with the primer/adhesive agents appear to only
retard rather then prevent bond degradation. It
is obvious that a different pathway needs to be
traveled and it is proposed the use of bioactive/
biomineralization integrating materials could be
the direction to success.
1. INTRODUCTION
The restoration of dental tooth structure
after it has been damaged by dental caries or
trauma has been the goal of the profession of
well over one hundred years. Over this time
the procedures performed have evolved from
extraction of the tooth, to the placement of cast
gold restorations, direct gold foil restorations,
amalgam restorations, porcelain jacket crowns,
porcelain fused to metal crowns and finally to
the use of glass ionomer restorations, bonded
adhesive restorations and pressed and milled
ceramics and zirconia. The ultimate goal being
Chapter
17
the creation of a long term beneficial method to
bring the dentition back to function and health.
In this chapter we will focus on the benefits and
challenges presented to us each day with the
utilization of resin bonding adhesive restorations
and look at the evolution currently going on that
is looking at a way to with the use of bioactive
materials create biomineralization and enable
our materials to work with nature not have the
natural protective mechanisms of the tooth
essentially “reject” our attempts to help the tooth.
2. THE HISTORY OF ADHESION
While at Eastman Dental Dispensary in
Rochester, NY (now the Eastman Institute
for Oral Health), Dr. Michael Buonocore [1]
had a paper published in the Journal of Dental
Research entitled “A simple method of increas-
ing the adhesion of acrylic filling materials to
enamel surfaces”. At that time there was a need
get the acrylic fillings of that time to adhere to
the tooth surface. He proposed the use of an acid
etch technique to enable this to occur. He stated:
“A filling material capable of forming strong
bonds to tooth structures would offer many
advantages over present ones. With such a
material, there would be no need for retention
and resistance form in cavity preparation, and
effective sealing of pits, fissures, and beginning
various lesions could be realized.”
This was the first step in attempting to create a
better adherence to the tooth structure: a way
of working so that a non-mechanical intimate
interface could be created. Dr. Ray Bowen [2],
in 1963, noted that there was a need to improve
the materials being used (silicate cements and
self cure methyl methacrylates), so that those
materials would have less solubility, sensitivity to
199
Regenerative Dentistry
Saad Bin Qassim
INTRODUCTION
To date most of the procedures performed in
dentistry are restricted to replacement of damaged
tissues for biocompatible synthetic materials that
may not present chemical, biological or physical
characteristics and behaviour similar to the host
tissue. These discrepancies altogether with the
hostile environment of oral cavity results in
relatively short lived successful clinical outcomes
and quite frequent needs of re-treatment [1].
Tissue engineering and regenerative medicine
(TERM) is a multidisciplinary field that has
evolved over the past few decades to recreate
functional, healthy tissues and organs in order to
replace and restore diseased dying or dead tissues
[2]. It employs the understanding of life sciences
for growth and development of new tissues. Next
it draws on advances in materials science and
engineering to amalgamate current engineering
design principles in the formulation of strategies
to engineering truly functional tissues. The field
then incorporates the therapeutic principles of
medical and dental clinicians in order to bring
the scientific side to practical application.
BIOLOGICAL TOOTH REPLACEMENT
AND REPAIR
Although there are an increasing number of
alternative treatments in dentistry most are non-
biological and are based on procedures that have
been practised for decades. The aim of stem
cell based tissue engineering is to reproduce an
embryonic tooth primordium from cultured
epithelium and mesenchymal cells. New bone
formation is a critical component of biotooth
formation. As biotooth has to be able to anchor
itself to the jaw bone with roots and periodontal
Chapter
18
ligaments [3]. Some of the prominent strategies
reported under this technique are the natural
tissue regeneration, signalling based strategies
and cell and gene based strategies. Progress in the
identification, isolation and understanding of the
differentiation of the adult and embryonic stem
cells altogether with a continuing understanding
of the control of tooth development will aid
the production and refinement of approaches
for biotooth formation. Although, there are
certain pitfalls and drawbacks, biological tooth
replacement is now a realistic possibility (Fig.
18.1) [4].
SCAFFOLDS
Scaffolds work as a temporary construct or
template that provides a three-dimensional
microarchitecture whereby cells are triggered to
attach, proliferate and differentiate to produce
desired tissue. Scaffolds should ideally mimic
extracellular matrix (ECM) of the natural tissues,
it should not only allow delivery of bioactive
molecules such as drugs or growth factors to
be able to allow oxygen influx to maintain high
metabolic demands of cells engaged in TE [6].
A number of techniques have been used for
the fabrication of non-porous and porous cell-
supporting scaffolds/constructs or templates
such as particulate leaching, phase inversion and
freeze drying, solvent casting, electrospinning
[7]. More recently additive manufacturing (3D
printing) have been considered as a potential
technique to fabricate biomimetic templates
of dental TERM [8,9]. However; drawbacks
include difficulty in controlling the pore size,
low interconnectivity, and residual salt and skin
formation.
213
Degradation and Durability of
Resin-Dentine Hybrid Layers
Jonathan Dixon and Salvatore Sauro
INTRODUCTION
Dr. Buonocore first introduced (1955) the ad-
hesion of resin-based materials to dental enam-
el. He proposed the use of phosphoric acid to
chemically condition the enamel, thereby form-
ing microporosities in which the resin can infil-
trate, creating tag-like projections [1]. Enamel is
composed of approximately 96% hydroxyapatite,
which is a solid crystalline structure [2]. It is
generally agreed that enamel bonding is predict-
able and successful when etched with phosphor-
ic acid [1]. Dentine, in terms of overall volume,
has a 50% inorganic component, 30% organic
component of which 90% is collagen, and the
remaining 20% is water [3,4]. The intrinsic wet-
ness and organic material in dentine decreases
the surface energy and, thus makes successful
bonding difficult; this in part explains the reduc-
tion in durability of resin-dentine bonds com-
pared to resin-enamel bonds [5]. Nakabayashi
et al. [6] in 1982 demonstrated the presence of
a hybrid layer. A resin-dentine hybrid layer is
made of a demineralized collagen fibrillar matrix
that is infiltrated by hydrophilic and hydropho-
bic resin monomers to form a micromechanical
bond [5].
Two different classes of dental adhesives can
form a hybrid layer; etch and rinse (ER) and
self-etch adhesives (SE) [2,7]. Etch and rinse
adhesives completely remove the smear layer
and demineralize the dentine superficially using
a phosphoric acid etchant, which is then rinsed,
followed by the application of a primer and bond
system or by a single-step one-bottle self-prim-
ing system [7]. Conversely, self-etch adhesives
partially remove the smear layer, using an acidic
primer and may be followed by the application
of a bonding resin depending upon the system
Chapter
19
employed by the clinician (e.g. two-step or all-
in-one adhesive systems) [7].Unfortunately, the
incomplete infiltration of adhesive systems into
demineralised dentine, particularly when an ER
approach is used, represents a clear problem de-
fying the clinical success of resin-based dental
restorations [8]. Most adhesive systems produce
very good immediate bond strengths but the
long-term strengths are a cause for concern [3].
Complete infiltration of resin into dentine
would be the ideal situation because acid etching
with phosphoric acid also uncovers and activates
endogenous proteins of the dentinal matrix,
such as matrix metalloproteinases (MMPs) and
cysteine cathepsins [9]. However, the complete
infiltration and replacement of all water by res-
in is often practically rarely achieved in prac-
tice, thus creating gaps within the hybrid layer
and leaving collagen fibres unprotected, which
decreases the durability of the resin-dentine
bond [1].Degradation of the hybrid layer, the
decreased durability of resin-dentine bonds and
the continued destruction of tooth structure, are
all very important and prevalent phenomena in
clinical dentistry and for this the author intended
to gather information and present a comprehen-
sive and comprehendible chapter to help clini-
cians understand and prevent such occurrences
in the future.
HYBRID LAYER DEGRADATION
Two main mechanisms have been identified to
constitute towards resin-dentine hybrid layer
degradation: intrinsic or proteolytic degradation
of the organic matrix and extrinsic or hydrolytic
degradation of the resin matrix [7]. Both mech-
anisms are interlinked, and decrease the durabil-
ity of resin-dentine bonds.
219
 Chapter

20
Introduction to Partial Denture
Shujah

PROSTHODONTICS 2. INDICATIONS FOR RPDs

Prosthodontics is the dental speciality pertain- a. Lengthy edentulous span
ing to the diagnosis, treatment planning, reha- b. No posterior abutment for a fixed prosthesis
bilitation and maintenance of the oral function, c. Excessive alveolar bone loss
comfort, appearance and health of patients with
clinical conditions associated with missing or d. Reduced periodontal support for a fixed
deficient teeth and/or maxillofacial tissues using prosthesis
biocompatible substitutes. e. Cross-arch stabilization of teeth
f. Need for immediate replacement of missing/
PROSTHESIS extracted teeth
An artificial replacement of an absent part of the g. Cost/patient desire
human body.
3. ALTERNATIVE TO RPDs
REMOVABLE PROSTHODONTICS
a. Fixed partial denture
b. Implant supported prosthesis
During Mixing c. Complete denture
d. No treatment. (Shortened Dental Arch)

Dental Maxillofacial Auxillary 4. DEMERITS OF PARTIAL

Prosthesis Prosthesis Prosthesis DENTURES
a. Stomatitis
b. Poor access for oral hygiene
Removable c. Caries
Dental Prosthesis d. Periodontal and endodontic lesions
e. Tooth mobility
f. Poor speech and mastication
Complete RPD Partial RPD
g. Bone resorption

COMMONLY USED TERMS

1. TREATMENT OBJECTIVES 1. SADDLE
a. Preserve remaining teeth The part of a denture that rests on the oral
b. Restore esthetics and phonetics mucosa and to which the teeth are attached.
c. Restore and/improve mastication
d. Restore health and quality of life

231